Pixel-accurate oncologic therapy using a scanning fiber endoscope

由于大多数癌症起源于上皮细胞，因此建议开发一种微创激光内窥镜来治疗早期癌症和 癌前病变。在膀胱癌的治疗过程中，许多早期癌症 未确诊，是所有癌症中复发率最高的。一种新型扫描光纤 内窥镜将发展为集成激光成像，早期肿瘤识别，分期， 以及使用局部使用的光敏剂染料进行治疗。为了提供对激光治疗的准确控制，体内成像和激光治疗都使用了相同的微型光纤扫描仪。这种双重功能将确保高强度激光的像素精确度传输。纤维扫描仪位于超薄(外径1.2 mm)柔性内窥镜的远端。初步测试将在人工组织活体模型和大鼠膀胱癌模型上进行，这些模型已经从培养中接种了癌细胞。由此产生的上皮内的浅表肿瘤将使用荧光图像引导的激光治疗以单像素的精度被摧毁。将使用两种治疗激光波长和光学癌症指标的性能评估来选择最有效的系统，同时考虑到效率和安全性。所有正在测试的系统在实践中都将具有高性能而不是低临床成本。此外，这项技术在肺癌、结直肠癌、食道癌、胰腺癌和胆管癌的早期治疗中也有广泛的应用。由于该项目的长度缩短，将不会开发用于评估实时反馈控制下的图像引导干预的剂量学的交互式计算机界面，目的是将对组织的附带损害降至最低。

Because a majority of cancers originate in the epithelium, the development of a minimally invasive laser therapy endoscope is proposed for the treatment of early cancer and precancerous lesions. During treatment for bladder cancer, many early cancers go undiagnosed, resulting in the highest recurrence rate of any cancer. A new scanning fiber endoscope will be developed for integrated laser imaging, early tumor identification, staging, and treatment, using topically applied photosensitizer dyes. To provide accurate control of the laser treatment, the same micro-optical fiber scanner is used for both in vivo imaging and laser therapy. This dual functionality will insure pixel-accurate delivery of the high-intensity laser light. The fiber scanner is located at the distal tip of an ultrathin (1.2 mm outer diameter) and flexible endoscope. Initial testing will be conducted on living artificial tissue models and a rat bladder cancer model that have been seeded with cancer cells from culture. The resulting superficial tumors within the epithelium will be destroyed using fluorescence image-guided laser therapy at single pixel accuracy. Performance evaluations of two therapeutic laser wavelengths and optical cancer indicators will be used to choose the most effective system, taking into account efficiency and safety. All systems under testing will have a high performance versus low clinical cost in practice. Furthermore, there is broad application of this technology to earlier treatments among lung, colorectal, esophageal, pancreatic, and bile duct cancers. Due to the reduced length of this project there will be no development of an interactive computer interface that estimates dosimetry of the image-guided intervention under real-time feedback control for the purpose of minimizing collateral damage to the tissue.